PURPOSE: Blood pressure (BP) monitoring is an essential procedure in intensive care. There is controversy about the reliability of non-invasive BP measurements in very preterm infants. This prospective trial compared non-invasive BP monitoring with BP monitoring via an umbilical arterial catheter (UAC) in this population. METHODS: Preterm infants born at less than 32 weeks gestation requiring a UAC for clinical management were eligible. Enrolled infants had up to three BP measurements on the right arm (RA) and right leg (RL) when in a resting state. UAC-BP measurements were noted immediately after the non-invasive BP was displayed on the monitor. Measurements were analysed in subgroups according to birth weight: no greater than 750 g, 751-1,000 g, above 1,000 g. Statistical analysis reports median, range, and Bland-Altman analysis. RESULTS: Sixty infants were included. Median (range) gestational age was 26.4 weeks (23.6, 31.2); birth weight 924 g (581, 1,518). A total of 1,865 measurements were performed (RA: 935, RL: 930). Mean difference (95% limits of agreement) for infants no greater than 750 g: RA 2.53 mmHg (-11.18, 16.24), RL -0.804 mmHg (-12.65, 11.04); for infants 751-1,000 g: RA 3.535 mmHg (-9.6, 16.7), RL -1.239 mmHg (-13.14, 10.66); for infants above 1,000 g: RA -1.65 mmHg (-13.47, 10.17), RL -4.101 mmHg (-14.17, 5.96). CONCLUSIONS: Although the average differences between invasive and non-invasive BP measurements are acceptable, the range of under- and overestimation of non-invasive BP measurements is large and not consistent, making reliance on non-invasive modalities to guide circulatory management problematic. If arterial BP monitoring is not available, our results suggest measuring non-invasive BP on the leg in preterm infants with a birth weight no greater than 1,000 g.
PURPOSE: Blood pressure (BP) monitoring is an essential procedure in intensive care. There is controversy about the reliability of non-invasive BP measurements in very preterm infants. This prospective trial compared non-invasive BP monitoring with BP monitoring via an umbilical arterial catheter (UAC) in this population. METHODS: Preterm infants born at less than 32 weeks gestation requiring a UAC for clinical management were eligible. Enrolled infants had up to three BP measurements on the right arm (RA) and right leg (RL) when in a resting state. UAC-BP measurements were noted immediately after the non-invasive BP was displayed on the monitor. Measurements were analysed in subgroups according to birth weight: no greater than 750 g, 751-1,000 g, above 1,000 g. Statistical analysis reports median, range, and Bland-Altman analysis. RESULTS: Sixty infants were included. Median (range) gestational age was 26.4 weeks (23.6, 31.2); birth weight 924 g (581, 1,518). A total of 1,865 measurements were performed (RA: 935, RL: 930). Mean difference (95% limits of agreement) for infants no greater than 750 g: RA 2.53 mmHg (-11.18, 16.24), RL -0.804 mmHg (-12.65, 11.04); for infants 751-1,000 g: RA 3.535 mmHg (-9.6, 16.7), RL -1.239 mmHg (-13.14, 10.66); for infants above 1,000 g: RA -1.65 mmHg (-13.47, 10.17), RL -4.101 mmHg (-14.17, 5.96). CONCLUSIONS: Although the average differences between invasive and non-invasive BP measurements are acceptable, the range of under- and overestimation of non-invasive BP measurements is large and not consistent, making reliance on non-invasive modalities to guide circulatory management problematic. If arterial BP monitoring is not available, our results suggest measuring non-invasive BP on the leg in preterm infants with a birth weight no greater than 1,000 g.
Authors: Sascha Meyer; Julia Sander; Stefan Gräber; Sven Gottschling; Ludwig Gortner Journal: J Paediatr Child Health Date: 2010-03-22 Impact factor: 1.954
Authors: J Wells Logan; T Michael O'Shea; Elizabeth N Allred; Matthew M Laughon; Carl L Bose; Olaf Dammann; Daniel G Batton; Stephen C Engelke; Alan Leviton Journal: Arch Dis Child Fetal Neonatal Ed Date: 2010-12-07 Impact factor: 5.747
Authors: Jonathan M Fanaroff; Deanne E Wilson-Costello; Nancy S Newman; Michelle M Montpetite; Avroy A Fanaroff Journal: Pediatrics Date: 2006-04 Impact factor: 7.124
Authors: S E Martens; M Rijken; G M S J Stoelhorst; P H T van Zwieten; A H Zwinderman; J M Wit; M Hadders-Algra; S Veen Journal: Early Hum Dev Date: 2003-12 Impact factor: 2.079
Authors: Ignacio Oulego-Erroz; Almudena Alonso-Ojembarrena; Victoria Aldecoa-Bilbao; María Del Carmen Bravo; Jon Montero-Gato; Rocío Mosqueda-Peña; Antonio Rodríguez Nuñez Journal: Eur J Pediatr Date: 2022-03-17 Impact factor: 3.183
Authors: Massimo Antonelli; Marc Bonten; Maurizio Cecconi; Jean Chastre; Giuseppe Citerio; Giorgio Conti; J R Curtis; Goran Hedenstierna; Michael Joannidis; Duncan Macrae; Salvatore M Maggiore; Jordi Mancebo; Alexandre Mebazaa; Jean-Charles Preiser; Patricia Rocco; Jean-François Timsit; Jan Wernerman; Haibo Zhang Journal: Intensive Care Med Date: 2013-01-22 Impact factor: 17.440